Alcohol Is What Ails Us.
Alcohol disorders are common in developed countries where it is: cheap, readily available, and heavily promoted. America checks all three of those boxes. Alcohol disorders also tend to be more prevalent in countries with high rates of mental disorders (depression, anxiety, etc), and the U.S. has that in spades. So it makes sense, then, that we have a significant alcohol problem.
36 percent of men and 23 percent of women will fit the DSM-5 criteria for an alcohol disorder at some time in their lives in America (Connor at al, 2016).
Alcoholism and alcohol disorders are among the most common and undertreated mental disorder in developed countries.
Yet, fewer than 15 percent of people receive treatment for their alcohol problem. Treatment for alcohol disorders, as well as diagnosis, is often delayed or even, does not occur at all. Why? One answer might be related to the fact that drinking, even large amounts, is commonplace. It's seen as a norm. And it’s often dismissed, laughed off, encouraged, or glamourized. Getting treatment for alcohol problems is also highly stigmatized.
It’s interesting given this a high stigma for getting treatment, but with little to no stigma for getting wasted regularly. If anything, our culture cheers this on and promotes this.
Alcohol consumption is causally linked to 60 different diseases including injury, liver disease, heart disease, stroke, various cancers, and gastrointestinal disease. (Connor et al, 2016).
The total harm caused by alcohol far outweighs any minor benefits.
Alcohol abuse and addiction used to be considered separate things, such as “harmful use” versus “dependence” or “alcohol use” versus “alcohol addiction.” Now, though, it is just “alcohol use disorder” in the DSM-5. And a person needs to have just two of the eleven symptoms in order to classify as having alcohol use disorder. The severity of this is then assessed by how many of the eleven criteria you have.
Prevalence of use increases in cultures that encourage lots of drinking, that offer alcohol at low cost, which allows its use in everyday settings (such as scotch tastings at work), and cultures that create a social milieu in which getting drunk is socially approved of and even promoted.
Other risk factors include a family history of alcohol issues, low parental monitoring, poor emotional family support, childhood conduct, impulsivity, mood disorders, low self-control, and positive alcohol experiences. Peer use is also a strong predictor. If your friends are big drinkers, you are way more likely to either be or turn into a big drinker yourself.
Drinkers often underestimate their consumption because standard drink units are poorly understood among most people.
The majority of people with a drinking problem have other substance use disorders too. At least half of them smoke cigarettes and a third have another drug use disorder.
Almost 50 percent of worldwide liver disease is linked to alcohol use.
AA is a decent treatment for some, especially for those with a low degree of social support, but the results of its success are quite a mixed bag (according to research).
Today in the medical community, tolerance and withdrawal are considered two key markers of alcohol addiction. Yet, what about people who are addicted to gambling or to starving themselves or cutting themselves? None of these have physical symptoms, though are still considered addictions.
Substances do alter the chemistry of the body and brain and thus, addiction to substances most certainly has a physical component. Yet, in journalist Johann Hari’s work, he references the experiments of Dr. Bruce Alexander and his experiment called “Rat Park.” These suggest that addiction is more than just physical. There is a distinct mental and emotional component too.
Initially, Dr. Bruce placed a rat in a cage without any toys, no other rat friends, zero alternate stimulation other than a water bottle laced with drugs. The mouse drank from the drug water almost constantly. A couple of rats even did it to the point of killing themselves. Dr. Alexander then wondered, what if he changed the situation? Would the result be different? He put the rat in a new cage, with a plethora of toys and other rats. All of the rats hardly touched the drug water at all, other than a couple of them once in a while. None of them used it to extreme or excessive degrees though.
What Dr. Alexander derived from this experiment is that drugs are used, in large part, because of a disinterest in being present in one’s situation or life. When our lives are filled with meaningful pursuits, goals, social connections, and work, we don’t want to get getting messed up all the time. Instead, we want to be present. Drug use is, in a sense, a form of avoidance, an attempt at escaping or numbing. People who want to be present in their lives do not tend to do this kind of thing often, for the very reason that they want to be present.
The journalist, Johann Hari, pointed out during his TED talk on this very topic, “most of you in the audience can likely afford to go home tonight and buy a liter of vodka, and if you’d like to, drink it over the course of this week. But you aren’t choosing to do so. Why not? Because you have lives in which you want to be present. You have relationships, jobs, personal projects, and family, for which you want to be present, engaged in, and sober.”
Thus, the criteria for how certain medical professionals are measuring alcoholism in the medical field is limited and flawed. One does not have to be physically addicted to alcohol to have a significant alcohol problem. We need to widen the definition of alcoholism past mere physical dependence since it does encompass more than this.
This same concept is explored in Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked by Adam Alter. He talks about Vietnam vets who came back, most of them heroin-addicted. Yet, the vast majority of them dropped heroin on their return to America and didn’t touch it again. They returned to their marriages, their work, their children, their friends, and their lives. Most of them reported no interest in the drug once they were away from both the boredom and horror of where they had been. This suggests a pull with drugs that is more emotional or mental, than merely physical (as we have been taught). Again, yes, there is a physical component, but the emotional and mental one is just as strong, if not potentially even stronger.
America considered liquor stores an “essential business” during pandemic shutdowns (though there is nothing essential about it). Alcohol sales have soared during COVID-19. Larger packs of beer, 24 and 30-packs, have gone up by 90 percent. Marketwatch.com says that alcohol sales have jumped 243 percent in the U.S. during Coronavirus. According to CNN, CBS, and NBC, alcohol sales have been on a steady increase along with the Coronavirus pandemic.
The problem is so concerning that the WHO issued a statement urging a restriction on alcohol access as it may worsen the immune system.
Why is all of this a significant issue?
Because over time, alcohol wrecks our physical health and our mental health.
Evidence shows that people who consume high amounts of alcohol are vulnerable to increased risk of developing mental health problems and alcohol consumption can be a contributing factor to some mental health problems. Meaning, it makes your mental issues worse, not better.
Roughly one-third of people struggling with an alcohol problem have a mental illness. And with dual diagnosis (meaning, you have both an alcohol problem and a mental illness), the symptoms of alcoholism and mental illness often feed off of each other. Because of this, any amount of alcohol will affect a person’s emotional well-being and vice versa.
Thus, people who are drinking to quell their anxiety, boredom, and depression are only feeding the problem. They aren’t helping it at all.
Alcohol depresses the central nervous system, and this can make our moods fluctuate more widely. It also ‘numbs’ our negative emotions temporarily, so we may avoid dealing with and facing difficult issues in our lives. All of those problems which are, of course, awaiting us when we are sober again.
Research shows that even just moderate drinking causes irritability, anxiety, and withdrawal symptoms.
And, even just moderate drinking (not necessarily heavy) has been linked to dementia (Alzheimer's).
When you drink too much, you’re more likely to make bad decisions or act on impulse. As a result, you are more apt to, say, drain your bank account, ruin a relationship, say things you regret, eat badly, use drugs, or make other terrible choices. When that happens, you’re even more likely to feel down, particularly if your genes are wired for depression. And so, it becomes a cyclical thing. Drinking, making bad choices, feeling depressed, and drinking some more.
Alcohol dependence is one of the main causes of disability in the U.S. and a strong risk factor for various diseases. We have got to stop turning to the bottle in order to try and manage our emotions. This does not improve our lives. In the very short-term, it can feel good. But soon thereafter, and over the long-term, drinking only amplifies our problems and makes our lives worse.